Paying Closer Attention To Your Symptoms Aids Proper Diagnosis.

History taking remains pivotal to making an accurate diagnosis. Even with the myriad of lab investigations available! Fact is that you can't investigate what you don't suspect, and you can't suspect what history doesn't suggest. Without history, you can do a myriad of lab investigations, and still be barking up the wrong tree. History sets you on the right path, and lab investigations ensures you get to the right destination.

The science of diagnostics stands on the tripod of history taking, physical examination, and lab investigation, each contributing roughly equal percentage to the final diagnosis. While physical examination is solely dependent on the doctor, and lab investigations on the relevant laboratory personnel, history taking, to a large extent is dependent on the patient. No matter how skillful one is in taking history, one can only document WHAT THE PATIENT TELLS HIM, unless such a person is gifted with psychic abilities. There lies the contribution of the patient to the diagnosis-making process.

It is easier to work with the patient who pays attention to his/her body, and observes even subtle changes, and minute deviations from the norm. Making diagnosis in such a patient is like following a road map. This is why the average gynaecologist prefers the patient who understands her reproductive cycles, and pays attention to it. And why the average paediatrician prefers taking history from the mother of a sick child, to taking it from the father.

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CASE SCENARIO: "Jacob's Voice, Esau's Body."

Sometime last week, I had a 22 year old young man brought to me with complaints of "worrisome headaches," that is severe enough to interfere with his everyday activity.

The headaches had started just few weeks after he gained admission into the university, to study his dream course, and was so severe he couldn't read. Typical Africans, they thought it was "sent from the village;" that their enemies didn't want him to become a graduate.

So, they took him to a traditional healer, and only came to me when the herbal concoctions weren't doing him any good.

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The headaches comes multiple number of times in a day, he said, especially when he is stressed. Severity worsens at night, interfering with sleep. Usually he sleeps for a few, and then wakes up with the excruciating headaches, so excruciating it makes him restless, drives him to be pacing about in pain, and makes him so "mad" he has this irresistible urge to bang his head on a wall.

He also gets sweaty palms, so sweaty he finds it difficult to hold,and write, with a pen. Then there was also the overt anxiousness, the palpitations [racing of the heart], excessive sweating, tremulousness, and excessive urination, in-between. All pointing towards a coexisting autonomic dysfunction.

Excruciating headaches in a stressed out adult MALE, that comes multiple number of times in a day, wakes him up from sleep, makes him restless, feeling like banging his head against a wall, and associated with autonomic symptoms, is MOST likely a CLUSTER HEADACHE.

As a rule of the thumb, Cluster occurs around the eyes, forehead, and temples, ON ONE SIDE OF THE FACE. And is usually associated with either, or all, of stuffy nose, tearing,redness of the eyes, drooping of the upper eyelid, narrowing of the pupils, sweating: all ON THE SAME SIDE AS THE HEADACHES. If it is not one-sided, and not associated with at least one of these, IT IS NOT

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So, on your next appointment with your doctor please don't withhold any information , every piece is very vital for an accurate diagnosis and perhaps your life depends on it.

THANKS FOR READING. DON'T WITHHOLD YOUR UPVOTES | RETEEMS | COMMENTS

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Yours in Health

Doc. Joe